Assessment of Provider-Initiated Testing and Counseling Implementation: Cambodia

In 2007, the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention recommended provider-initiated testing and counseling (PITC)—an approach in which health care providers offer routine HIV testing and counseling services to persons attending health care facilities as a standard component of medical care. That same year, Cambodia initiated “Healthcare Provider-Initiated Testing and Counseling,” in which health care providers in specialty clinics recommend routine referral for HIV testing at a voluntary confidential counseling and testing site. The approach varies from WHO guidelines in that it offers routine “referral” and not routine “testing.”

AIDSTAR-One conducted a rapid assessment of Cambodia’s approach to identify the following:

  1. 1) promising practices in HIV testing and counseling;
  2. 2) challenges experienced implementing routine referrals;
  3. 3) opportunities and barriers to the WHO PITC approach; and
  4. 4) opportunities to address unmet needs.

Interviews were conducted with health care providers, senior managers, voluntary confidential counseling and testing staff, and clients. A variety of themes emerged. Challenges were identified to introducing the WHO-defined PITC approach, including a need for staff incentives. AIDSTAR-One provides recommendations that define activities aimed to fill current gaps and could lay groundwork for implementing the WHO’s PITC approach in Cambodia.

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